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Understanding competence assessment culture: A qualitative study.

Ugo Caramori1, Natália Bortoletto D'Abreu1, Leonardo de Andrade Rodrigues Brito1

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Faculty understanding of competence assessment in competency-based medical education (CBME) often focuses on discrete components rather than real-world tasks. This analytic approach may hinder CBME

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Area of Science:

  • Medical Education
  • Health Professions Education
  • Educational Assessment

Background:

  • Competency-based medical education (CBME) is a global standard aiming to align medical training with healthcare system needs.
  • Successful CBME implementation hinges on a shared understanding of competence and its assessment, which can vary across institutions.
  • Faculty interpretations of competence assessment significantly influence the practical application of CBME.

Purpose of the Study:

  • To explore how faculty members understand competence assessment within a CBME framework.
  • To examine the implications of these understandings for the effective implementation of CBME.
  • To identify potential challenges and opportunities for advancing CBME.

Main Methods:

  • A qualitative, exploratory study was conducted at a public medical school in Brazil.
  • Twenty self-selected faculty members participated in semi-structured, online interviews.
  • Data analysis employed a deductive framework method, integrating four theoretical models from CBME literature.

Main Results:

  • Most faculty viewed competence analytically, as separate knowledge, skills, and attitudes, rather than a synthetic, task-based approach.
  • Assessment was primarily seen as certification, using multiple, non-integrated methods.
  • Outcomes were mainly framed for internal educational stakeholders, with limited patient or healthcare system focus.

Conclusions:

  • Local cultural understandings of competence assessment impact CBME implementation.
  • A gap exists between current assessment practices and real-world readiness, questioning certification legitimacy.
  • Advancing CBME necessitates contextual responsiveness and deeper engagement with faculty interpretations of competence.